This morning at breakfast I was surprised to find out that my husband approves of physician-assisted suicide. It was a heated discussion; I did most of the talking (surprise). By the end, he admitted he doesn’t know enough about it to judge it. I really don’t like it because I think:

1. People will want to end their life before they have fulfilled their “dying role.”
2. People will want to end their life before others have fulfilled their “dying role” in it.
3. It would be better to allow natural death at the onset of a terminal condition than to decide to prolong a life with medical technology and then decide at some point to use more technology to end that life.

In other words, I think it’s another way to medically mess up dying in a systems that’s already way too medically messed up. Perpetuated by the medical profession, we live our lives in denial that death will come. We don’t do the hard work of thinking about mortality, our own or other’s. We don’t practice caring and connection and compassion and letting go. We think there is a line between living and dying and that that line is our choice. It’s not. We are all dying. And we can’t control it. We can only control how we choose to live.

I choose to live in awareness (as much as possible) that each day counts and is a blessing. I hope that this means that when faced with death, I will accept it. I hope that when given medical treatment choices, I will choose only treatments that will be beneficial. I hope that when the end is near, I will go naturally, in a timely fashion, and painlessly, of course. If I have a debilitating, life-limiting condition, I hope that I will not have chosen to prolong my life with the aid of medical technology to the point where it would then be necessary to kill me with drugs. And if I have a painful condition, I hope I will be able to endure it, with the aid of compassionate and connected people taking care of me through to the natural end.

This will be my “dying role;” to figure out how to do that. I believe my dying role will be just as important as my living role – why would I cut short the experience of figuring out how to die when I have not shirked the role of figuring out how to live? The “unexamined life is not worth living” (Socrates); the unexamined death is not the way I want to go.

This will also be my loved ones’ “dying role.” They will have to figure out how to accompany me during my dying. I will not cut them off from that experience. I just pray that it is not too terrible for them. I would not ask them to do anything for me that I would not be willing to do for them. This is the crux of the matter for me. I am willing to be with someone as they are dying, whether that death is slow and excruciating and ugly, or swift, predictable and painless.

I have a friend who, in her mid-seventies, suffered a stroke, got an infection, and decided not to have a risky, complicated surgery with little chance for full recovery and a high chance for the need for medical care for the rest of her life. She died within a few months of the stroke. She was ready to die, not because she was depressed or unhappy, but because she had done the work to prepare for death. She had lived her life as though she had a finite amount of time to live. In fact, she had taken a local course called “Six Months to Live” based on the book A Year to Live, by Stephen Levine. She had thoroughly examined her views and spoken to many people about them, including her family. When it came time, she decided to walk the talk and live and die according to her beliefs. With the help of hospice care she had time to have closure and say goodbye and she died peacefully.

I know it is not the same for everyone. I know there are situations that are very different and difficult. I am so sorry for those people and I really don’t know what has led up to their wishing they could die but continuing to live. My realm of experience has been with hospice care, where people have accepted their mortality and lived fully with their condition, while not choosing life-prolonging medical treatment or machines. They have had someone to care for them, endured pain, received comfort, and died eventually, not usually neatly or tidily. What would have been different if they had chosen to die sooner? To say now, rather than later, to not wait for one more visit with a friend or distant relative, one more awkward trip to the bathroom, once more witnessing pain and sorrow in the face of their caregiver, one more asking for relief through touch or music, one more existential crisis in the middle of the night?

I don’t know, because I have never been in that situation. Having witnessed many hospice situations, even though some are very precarious, I do not fear hospice, for myself or for a loved one. What would lead someone to not choose that? Is the desire to have an assisted suicide due to a fear of living until the end? Is it a fear of pain? Is it a need for control? Is it a lack of resources? Is it an assumption that all the work of living is done? Or that all the work of caring is done? Is it the only way for some people? That makes me sad.

As for me, I want to work to help ensure palliative care, and caring people, for everyone. I want to make that more accessible. I think normalizing assisted suicide is a step in the wrong direction for our society. We have other work to do first.

“Canada Court Strikes Down Ban on Aiding Assisted Suicide” (NYT 2-7-15)